The bill amends section 3902.50 and enacts section 3902.80 of the Revised Code to establish regulations regarding the use of artificial intelligence (AI) by health insurers in Ohio. It updates the definition of the relevant sections by replacing the reference to section 3902.72 with section 3902.80. The new section 3902.80 outlines specific requirements for health plan issuers, including the annual submission of a report to the superintendent of insurance detailing their use of AI in utilization review processes. This report must include information about the algorithms used, data sets for training, and outcomes, among other details.

Additionally, the bill prohibits health plan issuers from making decisions about a covered person's care solely based on AI-derived results. It mandates that determinations of medical necessity must involve a licensed physician or qualified provider who considers the individual circumstances of the covered person. Any decisions made using AI must be accompanied by a clear explanation of the rationale. The superintendent of insurance is granted the authority to audit the use of AI algorithms by health plan issuers, ensuring compliance with these new regulations. The existing section 3902.50 is repealed as part of this legislative update.

Statutes affected:
As Introduced: 3902.50